Republic of the Philippines) S.S.

City of Zamboanga )
x------------x
AFFIDAVIT OF LOSS

I, Nico C. Lauron, Filipino, of legal age, single and a resident of Pasonanca,

Zamboanga City, Philippines, after being sworn to in accordance with law, depose
and state that:
1. I am a holder of a Non-Professional Driver’s License issued by LTO
Zamboanga City bearing No.: J04-09-006346 valid until 02 February
2023;
2. Sometime on 30 July 2020,when I arrived at home, I discovered that my
Driver’s License was no longer in my possession;

3. Diligent efforts to locate the same were rendered futile;

4. I execute this affidavit to attest to the truth of the foregoing and to
support my application for a new Driver’s License and for whatever legal
purposes it may serve.

IN TRUTH WHEREOF, I have hereunto set my hand this 24 th day of August

2020 at Zamboanga City, Philippines.

Nico C. Lauron
Affiant

SUBSCRIBED AND SWORN to before me this 24 th day of August 2020 at

Zamboanga City, Philippines. Affiant exhibited to me as her valid proof of identity,
UMID bearing CRN–021-1520-5589-2, issued at Zamboanga City.

Doc. No. 222; JOHN JASON N. ALBRECHT

Page No. 51; NOTARY PUBLIC
RD
Book No. 02; 3 Level, Edificio Coastal
Series of 2020; Corcuera Street, Zamboanga City
P.T.R No. 2037318, 06 Jan. 2020, Z.C
Roll of Attorney’s No. 67102
I.B.P O.R No. 103050, 03 Jan. 2020, ZC
Notarial Commission No. 40-2019